scholarly journals The Work behind Weight-Loss Surgery: A Qualitative Analysis of Food Intake after the First Two Years Post-Op

ISRN Obesity ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Angela A. Geraci ◽  
Ardith Brunt ◽  
Cindy Marihart
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Food Intake ◽  
Weight Loss Surgery ◽  
Exercise Adherence ◽  
Phenomenological Approach ◽  
First Year ◽  
Structured Interviews ◽  
Post Surgery ◽  
Bariatric Patients

Purpose. Obesity has reached epidemic proportions in the U.S. and has nearly doubled worldwide since 1980. Bariatric surgery is on the rise, but little focus has been placed on the psychosocial impacts of surgery. The purpose of this study was to explore experiences of patients who have undergone bariatric surgery at least two years before to gain an understanding of the successes and challenges they have faced since surgery. Methods. This study used a phenomenological approach, to investigate the meaning and essence of bariatric patients with food after surgery. Semi-structured interviews were conducted on a sample of nine participants who had undergone surgery at least two years prior. Findings. Two main themes regarding food intake emerged from the data: (a) food after the first year post-surgery and (b) bariatric surgery is not a magic pill. Upon further analysis, food after the first year post-surgery had four subthemes emerge: diet adherence after the first year post-surgery, food intolerances, amount of food, and tendencies toward coping with food do not magically disappear. Conclusion. Findings revealed that post-operative diet and exercise adherence becomes increasingly difficult as weight loss slows. Many participants find that only after the first year after surgery the work really begins.

scholarly journals Chew and spit (CHSP) in bariatric patients: a case series

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Phillip Aouad ◽  
Kristin Stedal ◽  
Gro Walø-Syversen ◽  
Phillipa Hay ◽  
Camilla Lindvall Dahlgren
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Disordered Eating ◽  
Weight Loss Surgery ◽  
Eating Pathology ◽  
Post Surgery ◽  
Significant Depression ◽  
Bariatric Patients ◽  
Clinically Significant

Abstract Background Studies into the disordered eating behaviour of chew and spit have alluded to several cohorts more likely to engage in the behaviour, one such group being bariatric surgery candidates and patients. Weight-loss surgery candidates have received little to no attention regarding engaging in chew and spit behaviour. Changes in pre- and post- surgery eating pathology related to chew and spit behaviour has yet to be explored and described in academic literature. Case presentation The current study reports on three cases of individual women, aged 30, 35, and 62 respectively, who indicated engagement in chew and spit. All three cases underwent bariatric surgery (two underwent gastric bypass, one underwent vertical sleeve gastrectomy). Eating pathology—including chew and spit behaviour, anxiety and depression, and adherence to the Norwegian nutritional guidelines were examined pre-operatively and post-operatively (one and two-year follow-up). At baseline (pre-surgery), two participants reported that they engaged in chew and spit, compared to one patient post-surgery. All three cases reported that they, to at least some extent, adhered to dietary guidelines post-surgery. Subjective bingeing frequency appeared to be relatively low for all three cases, further declining in frequency at one-year follow-up. At baseline, one participant reported clinically significant depression and anxiety, with no clinically significant depression or anxiety reported at follow-ups in participants that chew and spit. Conclusions The current study provides a starting point for the exploration of chew and spit as a pathological symptom of disordered eating in bariatric patients. It highlights the need to further explore chew and spit before and after weight-loss surgery.

scholarly journals Bariatric Biosociality: Pushed Together, Pulled Apart

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401989906
Author(s):  
Zoë C. Meleo-Erwin
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Loss Surgery ◽  
Structured Interviews ◽  
Severely Obese ◽  
History Of ◽  
Bariatric Patients ◽  
Provider Knowledge ◽  
Reconstructive Plastic Surgery ◽  
Reconstructive Plastic

This article explores the postoperative experiences of weight loss surgery patients. More specifically, it investigates why bariatric patients seek out and form connection to similarly situated others in online and in-person support forums. Based on a thematic analysis of 30 semi-structured interviews with individuals who have had bariatric surgery, it is argued that the experience of having been medically classified as obese or severely obese, a long history of failed dieting attempts, fears of future morbidity and mortality, and then undergoing bariatric surgery serve as an axis around which some individuals interact, create identity, and form community. The perceived lack of postoperative support from home bariatric clinics, inadequate provider knowledge about the particularities of bariatric bodies, and the fact that patients must “work with” their surgeries to avoid postoperative adverse events are additional drivers for the formation of such bariatric kinship. It is argued that Paul Rabinow’s concept of “biosociality” provides a helpful theoretical frame for understanding these processes. However, just as the aforementioned factors push bariatric patients together, tensions around the type of bariatric procedure undergone, the amount of weight loss, and economic access to reconstructive plastic surgery cause conflict, leading to the formation of subgroups within bariatric communities. It is argued that, ultimately, bariatric biosocialities are spaces in which bariatric patients collectively work to achieve normative health and aesthetic standards. However, these spaces also reflect highly complex, sometimes divergent and conflictual, and often ambivalent frameworks of understanding and experience.

scholarly journals Is Insulin Resistance at Baseline a Predictor of Weight Loss After Bariatric Surgery?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A18-A19
Author(s):  
Marta Borges-Canha ◽  
João Sérgio Neves ◽  
Fernando Mendonça ◽  
Maria Manuel Silva ◽  
Cláudia Costa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Cell Function ◽  
First Year ◽  
Model Assessment ◽  
Post Surgery ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

Abstract Background: Obesity is a multifactorial disease that is strongly associated to other metabolic disorders, such as insulin resistance and type 2 diabetes. Bariatric surgery is nowadays considered the most effective treatment of morbid obesity. The role of insulin resistance (IR) in weight loss after bariatric surgery is highly unknown. Aim: To evaluate the association between Insulin Resistance (IR) and percentage of excess weight loss (EWL%) one, two, three and four years after bariatric surgery in patients with morbid obesity. Methods: Retrospective longitudinal study in patients with morbid obesity followed in our centre between January 2010 and July 2018 were included. Patients were excluded if they had diabetes. We evaluated baseline Homeostatic Model Assessment of IR (HOMA-IR), Homeostatic Model Assessment of β-cell function (HOMA-beta), Quantitative Insulin Sensitivity Check Index (QUICKI) and Matsuda and DeFronzo index, and performed a linear regression concerning each year’s EWL%. Results: After applying the exclusion criteria, 1723 patients were included in this analysis. The logarithm of HOMA-beta was negatively associated with EWL% at second-, third- and fourth-years post-surgery (β=-1.04 [-1.82 to -0.26], p<0.01; β=-1.16 [-2.13 to -0.19], p=0.02; β=-1.29 [-2.64 to 0.06], p=0.061, respectively), adjusting for age, sex, body mass index and type of surgery. This was not observed in the first-year post-surgery nor for the other indexes. Glycaemia at baseline was also positively associated to EWL% at second- and third-years post-surgery. Conclusion: IR at baseline seems to be associated to long term weight loss, explicitly after the first year post bariatric surgery.

scholarly journals Cross-Sectional Analysis of Attitudes Towards Bariatric Surgery Tourism of Patients Attending a Weight Management Program: A Qualitative Study

2018 ◽  
Vol 6 (3) ◽  
pp. 100-109
Author(s):  
Paul Joonkoo Choi ◽  
Ryan Terrence Pereira ◽  
Áine Killeen ◽  
Gerard Thomas Flaherty
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Surgical Intervention ◽  
Management Program ◽  
Structured Interviews ◽  
Upward Trend ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Bariatric Patients ◽  
Sectional Analysis

Introduction: The upward trend of seeking bariatric surgery tourism will only grow with the globalization of medical care. We aim to describe the experiences participants of a supervised weight loss program in relation to their pursuit of bariatric tourism. Methods: Semi-structured interviews with an unbiased questionnaire were conducted to obtain a profound understanding of the current Irish bariatric surgery recruitment program and bariatric patients’ perception of it. Results: Analysis of interview data yielded 5 themes. Each theme was elaborated further with selected quotes from the coding process. Participants were asked to suggest potential solutions to current bariatric surgery and tourism support concerns in Ireland. Authors’ recommendations based on a literature review and the analysis of the interview transcripts are also provided. Conclusion: Any patients with morbid obesity and many years of attempted weight loss should receive a bariatric procedure to alleviate not only weight-related metabolic co-morbidities, but also the associated psychiatric burden. The currently available eligibility criteria and the lack of resources render an ideal surgical intervention inaccessible to many. Efforts must be made to scrutinize the efficacy of the existing criteria and the availability of resources. Alternatively, a bariatric tourism scheme that allows uninterrupted patient care should be developed.

scholarly journals All in the Family: Child and Adolescent Weight Loss Surgery in the Context of Parental Weight Loss Surgery

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 990
Author(s):  
Eleanor R. Mackey ◽  
Megan M. York ◽  
Evan P. Nadler
Keyword(s):  
Social Support ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Children And Adolescents ◽  
Family Support ◽  
Psychosocial Factors ◽  
Emotional Eating ◽  
Weight Loss Surgery ◽  
Food Addiction ◽  
Post Surgery

Background: Bariatric surgery is the most effective current treatment option for patients with severe obesity. More children and adolescents are having surgery, many whose parents have also had surgery. The current study examines whether parental surgery status moderates the association between perceived social support, emotional eating, food addiction and weight loss following surgery, with those whose parents have had surgery evidencing a stronger relationship between the psychosocial factors and weight loss as compared to their peers. Methods: Participants were 228 children and adolescents undergoing sleeve gastrectomy between 2014 and 2019 at one institution. Children and adolescents completed self-report measures of perceived family social support, emotional eating, and food addiction at their pre-surgical psychological evaluation. Change in body mass index (BMI) from pre-surgery to 3, 6, and 12 months post-surgery was assessed at follow-up clinic visits. Parents reported their surgical status as having had surgery or not. Results: There were no differences in perceived family support, emotional eating, or food addiction symptoms between those whose parents had bariatric surgery and those whose parents did not. There were some moderating effects of parent surgery status on the relationship between social support, emotional eating/food addiction, and weight loss following surgery. Specifically, at 3 months post-surgery, higher change in BMI was associated with lower perceived family support only in those whose parents had not had surgery. More pre-surgical food addiction symptoms were associated with greater weight loss at 3 months for those whose parents had not had surgery, whereas this finding was true only for those whose parents had surgery at 12 months post-surgery. Conclusions: Children and adolescents whose parents have had bariatric surgery may have unique associations of psychosocial factors and weight loss. More research is needed to determine mechanisms of these relationships.

A quality-improvement optimization pilot of BariFit, a mobile health intervention to promote physical activity after bariatric surgery

2020 ◽  
Author(s):  
Predrag Klasnja ◽  
Dori E Rosenberg ◽  
Jing Zhou ◽  
Jane Anau ◽  
Anirban Gupta ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Quality Improvement ◽  
Mobile Health ◽  
Text Messages ◽  
First Year ◽  
Mhealth Intervention ◽  
Steps Per Day ◽  
Bariatric Patients

Abstract Bariatric surgery is the most effective treatment for severe obesity (body mass index >40), helping individuals lose, on average, 25%–29% of their body weight over the first year. However, many patients begin to plateau and regain weight within 12–24 months, and 20% of patients begin to regain weight within 6 months postsurgery. As physical activity (PA) is an important predictor of weight loss and maintenance postsurgery, there is a need for scalable, effective lifestyle interventions to help bariatric patients increase PA in order to maximize their weight loss and maintenance. To assess feasibility of using mobile health (mHealth) tools to support PA postsurgery, we conducted a quality-improvement optimization pilot of BariFit, an mHealth intervention that combines commercial devices and custom text messages. Fifty-one bariatric patients enrolled in a 16-week optimization pilot of BariFit. To assess feasibility, pre–post changes in PA were assessed using activPAL. In addition, the pilot randomized, using a 2 × 2 factorial design, two adaptive approaches to daily step goals (variable and 60th percentile goals) and provision of rest days (yes/no), and microrandomized provision of SMS-delivered activity suggestions five times a day for each participant. Adherence to using study equipment was over 95% at 16 weeks. Participants increased PA by 1,866 steps from baseline to end-of-study (p < .007). Participants who received variable step goals averaged 1,141 more steps per day (p = .096) than those who received 60th percentile goals. Activity suggestions had no effect. mHealth interventions are feasible for supporting PA postbariatric surgery.

scholarly journals 0884 The Effect of Bariatric Surgery on Sleep Disordered Breathing in Adolescents and Young Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A336-A337
Author(s):  
A Koirala
Keyword(s):  
Bariatric Surgery ◽  
Heart Rate ◽  
Weight Loss ◽  
Young Adults ◽  
Sleep Disordered Breathing ◽  
Weight Loss Surgery ◽  
Sleep Architecture ◽  
Adolescents And Young Adults ◽  
Post Surgery ◽  
Children And Young Adults

Abstract Introduction Childhood obesity is the major risk factor sleep disordered breathing (SDB). Severely obese young people may require bariatric surgery for correction of obesity, if other methods of weight loss have failed. We aim to assess the effect of bariatric surgery on SDB, in adolescents and young adults. Methods We conducted a retrospective chart review study of patients who underwent bariatric surgery between January 1, 2006 and August 31, 2019 at Cincinnati Children’s Hospital. Only patients who had pre-operative and post-operative polysomnograms were included in the study. Results Twenty-seven children and young adults (female: 59.2%) met the criteria for entry into analysis. The mean age of subjects at the time of weight loss surgery was 17.9 years (range: 12.9 to 32.5). Majority of the patients underwent laparoscopic partial gastrectomy (85.2%) and the remaining underwent laparoscopic gastric bypass surgery (14.8%). The average duration of follow up for post study measurements after the surgery was 10.4 months (Range: 0.4 to 57.5). The median Body Mass Index (BMI) was significantly lower at post-surgery (49.9 kg/m2[IQR: 45.4-55.9][pre] vs 39.3 kg/m2[IQR: 33.9-46][post], P<0.001). The median obstructive AHI was significantly reduced at post-surgery (6.7/hr[IQR: 3.1-16.4][pre] vs 2.6/hr[IQR: 1.6-6][post], P= 0.03). Median heart rate (HR) during REM (79 bpm[IQR:67-90][pre] vs 67 bpm[IQR: 59.7-72][post], P<0.0001) and NREM (81 bpm[IQR:65-91][pre] vs 65 bpm[IQR: 58-73][post], P<0.0001) sleep were significantly lower at post-surgery. There was no statistically significant difference in sleep architecture (sleep latency, arousal index and percentage of REM, N1 and N3 sleep, P> 0.05) except N2 sleep (53.1% [IQR:47.7-57.3] [pre] vs 55.7% [IQR:51.4-63.7] [post], P= 0.03) which was significantly increased at post-surgery. Conclusion There was significant improvement in BMI and SDB after weight loss surgery in children and young adults. Interestingly, there was a decrease in heart rate during both REM and NREM sleep after surgery which may suggest a decrease in sympathetic activation due to improvement if SDB. The sleep architecture remained unchanged after surgery, except the percentage of N2 sleep. Support Cincinnati Children’s Hospital Research Foundation

scholarly journals Associations between Pre-Bariatric High-Sensitivity C-Reactive Protein and Post-Surgery Outcomes

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 721
Author(s):  
Tannaz Jamialahmadi ◽  
Mohsen Nematy ◽  
Simona Bo ◽  
Valentina Ponzo ◽  
Ali Jangjoo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Success Rate ◽  
Liver Stiffness ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Post Surgery ◽  
Hs Crp

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.

scholarly journals Utility of Fibroscan XL to assess the severity of non-alcoholic fatty liver disease in patients undergoing bariatric surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrew Yang ◽  
Melinda Nguyen ◽  
Irene Ju ◽  
Anthony Brancatisano ◽  
Brendan Ryan ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Convincing Evidence ◽  
Alcoholic Fatty Liver ◽  
Post Surgery

AbstractSignificant weight loss can modify the progression of Nonalcoholic fatty liver disease (NAFLD) with the most convincing evidence coming from bariatric surgery cohorts. Effective ways to non-invasively characterise NAFLD in these patients has been lacking, with high Fibroscan failure rates reported. We prospectively evaluated the utility of Fibroscan using XL-probe over a two-year period. 190 consecutive patients undergoing bariatric surgery were followed as part of their routine care. All patients had Fibroscan performed on the day of surgery and at follow-up a mean of 13 months (± 6.3) later. The majority of patients were female (82%) with mean age of 42. Fibroscan was successful in 167 (88%) at baseline and 100% at follow up. Patients with a failed Fibroscan had higher body mass index (BMI) and alanine transaminase (ALT), but no difference in FIB-4/NAFLD score. Mean baseline Liver stiffness measurement was 5.1 kPa, with 87% of patients classified as no fibrosis and 4% as advanced fibrosis. Mean baseline controlled attenuation parameter was 291, with 78% having significant steatosis, 56% of which was moderate-severe. Significant fibrosis was associated with higher BMI and HbA1c. Significant steatosis was associated with higher BMI, ALT, triglycerides and insulin resistance. Mean follow up time was 12 months with weight loss of 25.7% and BMI reduction of 10.4 kg/m2. Seventy patients had repeat fibroscan with reductions in steatosis seen in 90% and fibrosis in 67%. Sixty-four percent had complete resolution of steatosis. Fibroscan can be performed reliably in bariatric cohorts and is useful at baseline and follow-up. Significant steatosis, but not fibrosis was seen in this cohort with substantial improvements post-surgery.

scholarly journals Impact of the COVID-19 Pandemic on the Patient’s Decision about Bariatric Surgery: Results of a National Survey

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 756
Author(s):  
Maciej Walędziak ◽  
Anna Różańska-Walędziak ◽  
Paweł Bartnik ◽  
Joanna Kacperczyk-Bartnik ◽  
Andrzej Kwiatkowski ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Online Survey ◽  
Negative Impact ◽  
Weight Loss Surgery ◽  
General Information ◽  
Open Questions ◽  
Increased Risk ◽  
Bariatric Patients ◽  
The Moment ◽  
The Impact

Background: the COVID-19 pandemic and the implemented restrictions have changed the functioning of healthcare systems worldwide. The purpose of the study was to evaluate the impact of the present epidemiological situation on patients’ decisions about undergoing weight loss surgery. Methods: data were collected from 906 bariatric patients by the means of a national online survey, the majority of whom were women (87.9%). The survey started on 9 April 2020 and was open until 28 April 2020. The questionnaire included multiple choice and open questions, divided into three chapters: general information about the patient, life during the COVID-19 pandemic, and bariatric care during the COVID-19 pandemic. Results: despite the pandemic and the associated risk of COVID-19 infection, 443 responders (48.9%) would have decided to undergo bariatric surgery. Awareness of the negative impact of obesity on the course of COVID-19 illness had only marginable impact on patients’ decision-making (76.6% vs. 75.3%; p < 0.80). Contact with COVID-19 prior to the survey had a negative impact on the willingness to undergo bariatric surgery (3.0% vs. 4.4%; p < 0.55). There was a positive correlation between the BMI and preference for bariatric surgery in the time of the pandemic (37.4 ± 9.0 vs. 34.9 ± 8.7; p < 0.001). Conclusions: the level of awareness about the advantages of operative treatment of obesity is high among bariatric patients. The majority of patients awaiting bariatric surgery at the moment of the survey were positive about undergoing bariatric surgery despite the increased risk of a serious course of COVID-19 infection. Therefore, a large proportion of patients was determined to have bariatric treatment even during the pandemic, being aware of the increased risk of worse pace of COVID-19 disease in case of obesity and related diseases.

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